America is experiencing a superbug infection epidemic – maybe. We actually don’t really know because it seems that tens of thousands of superbug-related deaths go uncounted each year. What we do know is healthcare-acquired infections (HIAs) from drug-resistant bacteria is an ongoing issue for hospitals and health systems. With one family of nightmare bacteria able to grow in the presence of antibiotics, infection control, and prevention are more important than ever.
CRE: The Nightmare Superbug
It seems a class of bacteria known as carbapenem-resistant Enterobacteriaceae, or CREs, are more complex than researchers originally thought. You may have heard the story of a Nevada woman who died from an incurable CRE superbug infection. The U.S. Center for Disease Control and Prevention (CDC) tested a sample of the bacteria and found that nothing that is currently available in the United States would have cured the infection.
The Director of the CDC, Dr. Tom Freiden dubbed the term nightmare bacteria to describe CREs. This is because they are resistant to many antibiotics including carbapenems, which are a class of last-resort drugs.
CREs by the Numbers
Harvard University conducted a CRE study published in Proceedings of the National Academy of Sciences (PNAS) on January 16, 2017. They looked for cases of illness caused by CRE in four hospitals in the United States. One hospital was in California while the other three were in the Boston area. They found a wide variety of CRE species, suggesting that CRE is more widespread than previously thought. It may also be transmitting from person to person asymptomatically.
Researchers found that CREs share their antibiotic-resistant ways with the families of bacteria that make up the group. The way these bacteria transfer resistance genes from one family to another could be compared to a group of different kinds of criminals teaching each other their best (or worst) tricks.
The thing is, healthy people aren’t usually the ones contracting CRE infections. According to research from the CDC, it’s patients in hospitals, nursing homes, and other healthcare settings. Patients that need devices like ventilators, urinary or intravenous catheters, and patients taking long-term antibiotics are most at risk for contracting a CRE infection.
The CDC estimates that the CRE family of antibiotic-resistant bacteria is responsible for about 9,300 infections and 600 deaths each year. These bacteria can cause death in up to 50 percent of the patients that become infected.
Modern Infection Control and Prevention Methods
On any given time, one in 25 hospital patients will have at least one healthcare-acquired infection. That statistic coupled with the fact that we are unable to cure many of these infections suggests that new infection control and prevention methods are necessary to keep patients safer.
Obviously, tools and surfaces need to be thoroughly cleaned and disinfected, but traditional methods are falling short. However, new technologies are giving healthcare systems better infection control and prevention methods. Here are a few infection control and prevention trends you can expect to see this year:
Ultraviolet (UV) light can be used to disinfect a room and is often in the former rooms of patients that had any type of antibiotic-resistant illness. This helps prevent the spread of the infection to incoming patients. If you are working in a healthcare system that is not using UV light for sterilization, I can almost promise you they will be using it by the end of 2017.
Real-Time Hand Hygiene
We all know the importance of hand hygiene adherence as it applies to infection control and prevention. There are now real-time technologies that can help detect usage. By attaching sensors to soap or sanitizer dispensers, real-time location systems (RTLS) can let supervisors know if a staff member has washed or sanitized their hands before and after visiting with a patient.
Hospitals that use real-time location technology for this purpose can expect to see hand hygiene adherence increase significantly. Using RTLS, you can also follow the reverse path of an infected individual to find how they came in contact and where. This will allow healthcare systems to find where some of their sneakier HIAs are occurring in the hospital.
Rapid Diagnostic Testing
One major part of infection control and prevention is identifying the organisms. If you cannot identify a particular germ, you’re going to have quite a hard time controlling or preventing infections. Rapid diagnostic tests allow scientists to identify specific bacterium with 24 hours, which is faster than the usual 3 to 5 days.
While you’re on your travel physician assignments this year, expect to see more healthcare systems adopting rapid diagnostic technologies. Healthcare organizations that do this will likely see shorter admission times and better patient outcomes.
Though advances need to be made in the treatment of CRE infections, the best way to stop these bacteria is by preventing transmission in the first place. In 2017, healthcare systems will need to make a concerted effort to implement modern infection control and prevention procedures. With the shift from volume to value-based healthcare occurring, hopefully, healthcare systems will include infection control and prevention in those efforts.